Being on time

I think my previous blog post totally jinxed my day in the OT! From non-happening to completely happening...

It started all well, I woke up earlier than planned, grabbed breakfast and headed up to the OT. But then...I got scolded for being 3 minutes late... Sweet...
Don't get me wrong, I do understand the importance of being punctual and I actually put a lot of emphasis on it so I guess instead of finding 101 excuses of why I was late, I should just accept that I was slightly late and make sure that I arrive earlier.

And for some weird reason, I had decided to not properly fill my logbook and yes I got a bit scolded again! Totally my fault that I did not properly record the procedures correctly on my log sheet.

Anyway since I did not record that I performed bag-valve-mask during the days I have been in the OT, I was asked to do so on the patients who came in for ECT. I guess I should somehow be thankful because I finally managed to learn (under pressure) how to properly maintain an airway and manually ventilate a patient.

The rest of the day was quite normal if I may say so.  I observed an epidural being done and had an opportunity to observe how the anesthetist manages a patient with multiple co-morbidities, which was interesting and confusing at the same time.

My anesthesia posting is not so bad after all!

Anesthesia

It is ironic how every time something interesting happens, I think about writing it on the blog but by the time I reach home, I’m too drain out to even type it out.  And eventually, this poor little blog is left neglected.

Well anyway, I am now doing anaesthesia and I’ve been meaning to share with you my thoughts about how I am finding this new rotation.

Even before starting anaesthesia, I had this voice in my head telling me that it was going to be a boring two weeks in the OT but I had to remind myself to stop being judgemental and to give it a chance.

I must say that it was one of the few rotations where I got a proper introduction by the clinical supervisor and later on, we attended a small clinical workshop on intubation. I have had three days in anaesthesia so far but I haven’t had to chance to intubate any patients yet. I hope that I will have the opportunity to do so later on in the rotation.

How the days go about depend entirely on who I am attached with. There are some doctors who are enthusiastic to teach, others who happily answer all of my silly questions and then there are those who do not want to be disturbed and who don’t want me to touch anything at all.

Sometimes I take a small stroll out of the OT and go observe the ECTs that are being performed. I think that my love for psychiatry takes over me from time to time and I think it is pretty obvious at times. One anaesthetist turned to me and asked ‘Are you interesting in psychiatry?’ and I happily nodded of course!

I usually spend the rest of my time in the OT reading my book and asking questions if the doctors are willing to answer me. Otherwise, I stared at the GA machine or watch the surgery, wondering how long did the surgeons trained to be where they are now.

Anyway that is how my first three days in anaesthesia have been so far.  I hope that I will enjoy myself during the rest of the posting.

Do not guess!

After a patient was stabilized in the red zone, the ED physician gathered all the students around and asked us to interpret an ABG.

A simple answer like metabolic acidosis was not enough... I forgot to add with hypoxia! And being dramatic in nature, the tutor sure had his way around making us (or at least me) feel like a total idiot. He kept on questioning us about different aspects of an ABG as well as how to deal with a patient with acute pulmonary oedema. Unfortunately, we all made the biggest mistake when answering some of his questions: GUESSING!

Anyway after what seemed to be a lengthy bedside tutorial with him, one of the main message was:
When you are in the ED and you don't know something, say you don't know and do not guess as this might lead to the death of your patient!
He added that if we were in the medical wards, we could go ahead and guess and come back one month later and change the diagnosis....as I said, he is a bit dramatic :p

Well, lesson learnt! I think that as a medical student, even when I am not sure, I either tend to guess things or say what I am thinking.
I think that this has both its advantages and drawbacks.
Speaking your mind during a bedside teaching is actually beneficial in my learning process and it also shows that your mind is working rather than just nodding like a parrot.  But in some instances, especially in emergency cases, guessing would probably lead to the death of the patient!

I think the message he really wanted to bring out was to know your limitations as a doctor in terms of knowledge and abilities and to accept the help of more senior personnel when you are unsure about what to do.